Comorbidities in Nigerian patients with rheumatoid arthritis

Rheumatoid arthritis has been infrequently reported among African black populations. Recent data have shown increasing reportage. Comorbidities are increasingly recognised as important in the overall morbidity, mortality and response to management. There have been few reports from Africa on the frequency and role of comorbidities associated with rheumatoid arthritis (RA) in Africans.

This 20-year retrospective study looked at the frequency of various comorbidities among Nigerian patients with rheumatoid arthritis from a rheumatology facility. Data were obtained from the case record files of 283 RA patients. The chi-square test was used to assess the relationship between patient characteristics and the presence of comorbidity, while logistic regression was used to determine factors that were independently associated with the occurrence of comorbidities in these patients.

The frequency of comorbidities among RA patients is high at 52.3%, mainly from common conditions such as hypertension (22.3%), dyslipidaemia (11.3%), osteoarthritis (8.1%), diabetes mellitus (7.1%), peptic ulcer disease (6.4%) and interstitial lung disease (3.5%). Increasing age (χ² 47.74, P<0.001) and prolonged duration of symptoms before diagnosis (χ² 9.0, P = 0.02) were significantly associated with the presence of comorbidity on univariate analysis, and only age was found to be independently associated with comorbidities on logistic regression.

The frequencies of these comorbidities are similar in certain aspects to other such reports but differ from others. An important factor may be the delay in presentation to a rheumatologist. It is hoped that other more extensive studies will elucidate some of these findings.